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					                                          Health Care
                                         Unit Materials
                                        Table of Contents


       Page                                               Title

         1             Table of Contents
         2             Teacher Checklist – Unit Benchmarks
         3             Student Checklist – Unit Goals
        4-5            Response Questions for Nursing Assistant Videos
         6             Reading: Active Listening
         7             Active Listening Practice
        8-9            Guide Cards for Active Listening Skills
       10-11           Visit from a Nursing Assistant – question / answer sheet
       12-13           Career Pathways Chart
        14             Field Trip Learning Guide
        15             Career Discovery Journal – Cover Sheet
        16             Polite Greetings, Requests and Offers
        17             Practice with Modals for Requests and Offers
       18-20           How to Help a Resident Sit Up in Bed
        21             Discussion Guide for Visit from Pre-CNA students
        22             How to Help a Resident Eat
        23             Performance Evaluation Form
       24-25           Medical Records – reading and chart/questions
        26             Blank medical Chart
        27             Complete Sentences or Notes?
        28             Writing Notes in a Medical Chart
       29-30           Fact or Opinion? chart and cards
        31             References



Althea Danielski – Hubbs Center EL Civics 12/18/09                                1
                                                     Learner




                                                         Active Listening
                                                         demonstration




Althea Danielski – Hubbs Center EL Civics 12/18/09
                                                         *AP 1-3


                                                         Use polite words
                                                         and phrases for
                                                         greetings and
                                                         requests, with
                                                         conditional &
                                                         imperative
                                                         * AP 2-1

                                                         One nursing
                                                         assistant skill:
                                                         either helping a
                                                         resident sit up in
                                                         bed, or feeding a
                                                         resident * APs 2-2
                                                                                                                           (E = emerging, A = approaching, P = proficient)




2
                                                         or 2-5

                                                         Evaluate peers &
                                                         self on simple
                                                         evaluation forms
                                                         * AP 2-7
                                                                              Class _English for Careers_______________ Profile: Unit __Health Care________________Benchmarks




                                                         Essay completed :
                                                         Is a Health Career
                                                         Right for Me? *
                                                         AP 1-7
                                                                                    *Measuring instrument (Activity Product-AP, Culminating Activity-CA, Post Test-PT, Daily Observation-DO, Hand-out-HO, etc.)
                                       Student Checklist

 Name: ________________________ Class: __English for Careers________

 Unit: _Health Care______________                  Completion Date: ________________


 Circle the word that shows how you feel about each benchmark.


          Benchmark                           Before Unit                 After Unit
                                       Difficult      So-so   Easy Difficult   So-so       Easy
1. Use Active Listening.
                                                                                       

                                       Difficult      So-so   Easy Difficult   So-so       Easy
2. Use polite words and phrases
                                                                                       
   for greetings and requests.
                                       Difficult      So-so   Easy Difficult   So-so       Easy
3. Help a resident sit up or eat.
                                                                                       

                                       Difficult      So-so   Easy Difficult   So-so       Easy
4. Evaluate yourself and your
                                                                                       
   classmates.
5. Write a paragraph about how
                                       Difficult      So-so   Easy Difficult   So-so       Easy
   you feel about working in
                                                                                       
   health care.
6.
                                       Difficult      So-so   Easy Difficult   So-so       Easy
                                                                                       




 Althea Danielski – Hubbs Center EL Civics 12/18/09                                    3
                       Response questions for Nursing Assistant Videos
Watch the Nursing Assistant videos (there are three). Stop and answer the questions for the videos after
you watch each one. Share what you wrote with a partner or small group.

First video: I Am a Nursing Assistant

Youtube: http://www.youtube.com/watch?v=ho_cY9qoAFw

   1. What do nursing assistants do for residents? ___________________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   2. What do nursing assistants do for nurses? _____________________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   3. How do the nursing assistants feel about their work? ____________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

Second video: What Makes a Great Nursing Assistant

Youtube: http://www.youtube.com/watch?v=pg43mfFBqf4

   1. What do residents say is important for a nursing assistant to do? ___________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   2. How do residents know that nursing assistants care about them? ___________________________


       _______________________________________________________________________________

       _______________________________________________________________________________
Althea Danielski – Hubbs Center EL Civics 12/18/09                                              4
Third video: Diary of a New CAN

Youtube: http://www.youtube.com/watch?v=QtcX713_a4U

   1. Why did she become a CNA? ______________________________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   2. What are some of the job duties she names? ___________________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   3. What does she like the most about her job? ___________________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   4. What do you think is the most difficult part of her job? __________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________

   5. Do you think she likes her job? Why or why not? _______________________________________


       _______________________________________________________________________________

       _______________________________________________________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09                                      5
                              Active Listening
Active listening is a form of careful listening and response to a speaker to
let them know that they are heard and understood. Active listening builds
good communication, understanding and trust. It involves verbal and non-
verbal techniques. It is an art as well as a skill, and requires practice.

Verbal Active Listening Skills

   1. Repeating: To show you are listening, repeat what you think the person said. Don’t use the exact
      same words, but paraphrase (use your own words) and summarize. For example, “Let’s see if I
      understood. You said…”


   2. I’m listening cues: Show the person you are listening and encourage them to continue with words
      or phrases such as “Oh?” “Really?” “mmm-hmm,” “Then?” “I understand,” “And?”


   3. Reflecting: Reflect the speaker’s words in terms of feelings. For example, “This seems really
      important to you…”


   4. Giving feedback: Let the person know your first thoughts about what they said. Share important
      information and observations. Put the speaker’s feelings into words, for example, “It seems like
      you’re feeling frustrated… worried… anxious…”


   5. Use “I” statements: By using “I” statements, you focus on the problem, not the person. This lets
      the person know what you feel and why. For example: “I know you have a lot to say, but I need
      to…”

Non-Verbal Active Listening Skills

   1. Eye contact: Look at the speaker in the eyes while they speak to you.


   2. Body language: Stop other activities and turn your body towards the speaker. Sit or stand close
      enough that they know you can hear them. Use facial expressions to show you care about what the
      person is saying.


   3. Touching: If appropriate, touch the speaker on the hand, arm or shoulder. Touch is often more
      powerful than words.


   4. Silence: Let comfortable silences slow down your conversation. This gives the person time to
      think as well as talk.

Althea Danielski – Hubbs Center EL Civics 12/18/09                                            6
Adapted from The Art of Active Listening, 2005 National Aging I&R Support Center, Washington, D.C.
http://www.nasua.org/pdf/TipSheet1ActiveListening.pdf and The Art of Active Listening, Self-Help
Network, Center for Community Support & Research, Wichita State University.
http://www.selfhelpnetwork.wichita.edu/images/pdf/ActiveListening.pdf

                                        Active listening practice
Practice active listening with a partner. Ask your partner the questions below. Listen actively, using the
skills described above. Then your partner will listen to you.

Practice until you both feel ready to show your active listening skills to the class in a demonstration.

Questions:     1. How are you feeling today?

               2. Is there anything that you are worried about?

               3. How is your family?

               4. Tell me something that makes you feel happy.

               5. Think of your own question to ask. ___________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09                                                 7
Guide Cards for Active Listening Skills

                                                      How did you feel when
 Tell me about your best                              you first arrived in the
         friend.                                               USA?
                                                     Would you like to go back
  How do you feel about                               to your home country
   living in Minnesota?                                     someday?
      Tell me about your                               What is one thing you
       mother or father.                              would change about the
                                                              world?
 What are you proud of?                               Describe your favorite
                                                             holiday.
      What kind of work                              What would you do if you
       interests you?                                could have any job in the
                                                             world?
   What is your favorite                               What is one thing you
   thing about school?                                don’t like about school?
   What is one thing you                             What do you worry about
   would change about                                    in your family?
        yourself?

Althea Danielski – Hubbs Center EL Civics 12/18/09                         8
Describe the best teacher Describe the worst teacher
     you ever had.              you ever had.
  If you could meet any                              Describe something that
 person in the world, who                                  scares you.
would you meet, and why?
 Describe something that                              Tell me about the time
  makes you feel angry.                                you first fell in love.
    What is the most                              If you had an important
 important thing in your                         secret, and you could only
     life right now?                             tell one person, who would
                                                           you tell?
 What is more important                              Is it more important to be
 in life, health or wealth?                                honest or kind?




Althea Danielski – Hubbs Center EL Civics 12/18/09                         9
                                 Visit from a Nursing Assistant
Tomorrow we will have a Nursing Assistant come to our class to talk about her work. What questions
would you like to ask him/her? Write them here. There is room for you to take notes on her answers.

Your questions:

   1. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________

       _______________________________________________________________________


   2. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________

       _______________________________________________________________________

   3. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________

       _______________________________________________________________________


   4. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________


   5. _______________________________________________________________________


       His/her answer: _____________________________________________________________


Althea Danielski – Hubbs Center EL Civics 12/18/09                                          10
       _______________________________________________________________________

       _______________________________________________________________________


   6. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________

       _______________________________________________________________________


   7. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________

       _______________________________________________________________________


   8. _______________________________________________________________________


       His/her answer: _____________________________________________________________

       _______________________________________________________________________

       _______________________________________________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09                             11
                                   CAREER PATHWAY ______________________

GOAL __________________                                    BY WHEN ______________________



JOBS




TO MOVE UP




INFO
I NEED




Althea Danielski – Hubbs Center EL Civics 12/18/09               12
                                             CAREER PATHWAY – Example – Health Care

GOAL ___LPN_______________                                                      BY WHEN ____5 years_____________

Note to teachers: Have students generate this as a class on a blank template.

JOBS

  Volunteer at                          Home Health                      Nursing                        Licensed
  Nursing                               Aide                             Assistant                      Practical
  Home                                                                                                  Nurse (LPN)




                   Pre-CNA class                      CNA class                      LPN program at
TO MOVE UP                                                                           community
                                                                                     college




INFO
                                                                                       How long will it take
I NEED                  What CASAS                      Where/how do I                 to get LPN license?
                        score do I need to              take the CNA
                        get into the Pre-                                              How much will the
                                                        class?                         LPN program cost?
                        CAN class?




Althea Danielski – Hubbs Center EL Civics 12/18/09                                      13
                                  Field Trip Learning Guide

   A. What will we watch for?


       1. _________________________________________________________________


       2. _________________________________________________________________


       3. _________________________________________________________________


       4. _________________________________________________________________



   B. What questions will we ask?


       1. _________________________________________________________________


       2. _________________________________________________________________


       3. _________________________________________________________________


       4. _________________________________________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09                 14
          Career Discovery
              Journal




Name
Date


Althea Danielski – Hubbs Center EL Civics 12/18/09   15
                               Polite Greetings, Requests and Offers


Greetings

When we see someone for the first time each day, we greet them in a polite and friendly way. Practice
these greetings:
     “Hello, Mrs. Cardiz! How are you today?”

        “Good morning, Mr. Rivera. How are you feeling?”

        “Good afternoon, Mrs. Han. How is everything?”

        “Good evening, Mr. Ali. Have you had a good day?”

        Can you think of another friendly greeting?

Now practice greeting your teacher and classmates.


Requests

When we need to ask someone to do something, we can show respect by using the word please, and using
modal helping verbs, such as can, could, and would to form a question. Adding these words makes the
request more polite.

Try using these phrases:
    Please sit up.

        Can you roll up your sleeve, please?

        Could you please lift your knees?

        Would you please roll over on your left side?

Try asking your teacher and classmates to do things, using these phrases. (Examples: Please stand
up. Could you give me your pen? Would you tell me your name again, please? Etc.)


Offers

We use the modal helping verbs can, could, may, and would when we offer to do something for
someone.

Try these phrases:
    Can I get you another cup of coffee?

        Could I help you brush your hair?

Althea Danielski – Hubbs Center EL Civics 12/18/09                                           16
      May I give you a bath now?

      Would you like to take a walk in the garden?

Try offering to do things for your teacher and classmates. Examples: (Can I help you with your
chair? Would you like me to open the window blinds? Etc.)

                         Practice with modals for requests and offers

Writing: Work with a partner. Make requests and offers, using can, could, would and may. More than
one answer is possible.

Ask a resident to…

       1. tell you how she slept last night.

       _______________________________________________________________________________

       2. open her mouth.

       _______________________________________________________________________________

       3. take off her eyeglasses.

       _______________________________________________________________________________

       4. push the signal light when she’s done using the toilet.

       _______________________________________________________________________________


Ask a resident if you can…

   1. turn on the television for him.


       _______________________________________________________________________________

   2. give him a massage.

       _______________________________________________________________________________

   3. get him another glass of juice.


       _______________________________________________________________________________

   4. read his birthday cards to him.


Althea Danielski – Hubbs Center EL Civics 12/18/09                                        17
       _______________________________________________________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09                           18
                How to Help a Resident Sit Up in Bed

Watch the video* on how to help a resident sit up in bed. Then, watch
again, filling in the blanks in the instructions below.


       We’re going to show you how to help your loved one get to the edge of the bed, concentrating on

your own ____________________________________ so that you’re not bending over and bending your

back and putting yourself ___________________________________________.

       The easiest way to do it is to have them bend up their knees, have them reach their arm across

their body, grab their __________________________________________, and roll them towards you.

You’re going to bring their legs off the bed, and then have them ______________________________ and

you push with your arms and bring them up, concentrating on using ______________________________

instead of your upper body.




Questions:

   1. What are “body mechanics?”




   2. Why is it important to concentrate on your body mechanics when you are helping to move
      someone?




   3. Why is it important to use your legs instead of your upper body when you push someone up?




Althea Danielski – Hubbs Center EL Civics 12/18/09                                            19
                              How to Help a Resident Sit Up in Bed

Now, write the instructions again, in your own words, as you remember them. Try to write them
without looking back at the first page. After you write the instructions, check the first page to see
how much you remembered. Add or change what you wrote, so that you don’t leave anything out.



____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________



Now it’s your turn to try it out!

Put together two tables so that a volunteer can lay down on them. (Use the sleeping pads to make the
tables more comfortable to lie on.) Practice helping the person sit up several times, until you feel
confident that you know how to do it correctly. Say each step out loud as you do it, to remind yourself and
to make sure you do them all. Then, demonstrate the procedure to the class.




Althea Danielski – Hubbs Center EL Civics 12/18/09                                               20
For the teacher: transcript from video



We’re going to show you how to help your loved one get to the edge of the bed, concentrating on your

own body mechanics so that you’re not bending over and bending your back and putting yourself at risk

for getting hurt. The easiest way to do it is to have them bend up their knees, have them reach their arm

across their body, grab their shoulder and their hips, and roll them towards you. You’re going to bring

their legs off the bed, and then have them push up and you push with your arms and bring them up,

concentrating on using your legs instead of your upper body.


* Video by the Memory and Aging Center, University of Southern California; downloaded from
YouTube on 10/10/09 (http://www.youtube.com/watch?v=UDJ8BkRO6iM).




Althea Danielski – Hubbs Center EL Civics 12/18/09                                              21
                       Discussion guide for visit from Pre-CNA students


Introduce the Pre-CNA student volunteers, and then allow them to introduce themselves – where they are
from, how long they’ve been in the U.S., how long they’ve been studying at the Hubbs Center, etc.


Part I: Ask the Pre-CNA volunteers to answer questions about their career path. Allow students to
generate the questions first, but if they need prompting, here is a good list to use:
   1. When did you decide to study nursing?

   2. Why did you decide to go into nursing?

   3. What kind of job would you like to get right away (short term goals)?

   4. What kind of job do you want to have in the future (long term goals)?

   5. How are you going to get your first job?

   6. How will you reach your final goal?

   7. What is the Pre-CNA class like? What do you like about it? What is difficult about it?

   8. Do you have any suggestions for those of us who want to take the class?



Part II: Divide into groups, so that each group has one Pre-CNA student. Ask the groups to discuss
(write topics on the board):
   1. Barriers to communication with residents/patients

   2. How culture and religion can affect communication

   3. Different forms of communication: spoken communication, body language, touch, etc.

   4. Communication methods (listening, direct questions, silence, etc.)

   5. Strategies for overcoming barriers to communication

Each group should make a list of strategies for communicating with residents/patients. This list should be
written in the Career Discovery Journals.
Althea Danielski – Hubbs Center EL Civics 12/18/09                                             22
Althea Danielski – Hubbs Center EL Civics 12/18/09   23
                               How to Help a Resident Eat


       Some residents are unable to feed themselves because of weakness,

paralysis, or other physical problems. They are fed by the care team.

       Keep in mind that residents who need to be fed are sometimes embarrassed, ashamed or angry.

Some may be depressed, and may refuse to eat. Let them do as much as possible, managing finger foods

(bread, crackers, etc.) or cold drinks.

       Follow these guidelines* when feeding a person.

       1. Put a napkin under the chin and across the resident’s chest.


       2. Tell the resident what foods and drinks are on the tray.


       3. Ask what foods and drinks the resident would like, and in what order.


       4. Use a spoon to feed the resident (forks may cause an injury). Fill the spoon only 1/3, to

           prevent choking.


       5. Allow the resident to chew and swallow before giving another spoonful.


       6. Use straws in the drinks if the resident cannot drink out of a cup.


       7. Sit down while you feed the resident and talk to them in a pleasant manner.


       8. Wipe the resident’s mouth with a napkin when food is on the person’s face.


       9. Clean the resident’s face or hands with a damp washcloth after the meal.


       10. Note how much and which foods were eaten. Record this on the resident’s record.


       *Modified from Basic Skills for Nursing Assistants in Long-Term Care, 2005.




Althea Danielski – Hubbs Center EL Civics 12/18/09                                             24
Now you try it! Work with a partner. Feed them a meal following the guidelines above, and then let
them feed you. Evaluate your partner’s work using the rubric created yesterday.

       QUESTIONS:
         1. What was difficult about feeding your partner? What was easy? Did anything surprise you?


          2. How did it feel to be fed? How do you think people feel when they are fed every day?


     Performance Evaluation: ___________________
                                                     (Procedure)


Instructions:
     1. Write 4 steps involved in doing the procedure. (Helping a
       resident sit up in bed, or Helping a Resident Eat.)
     2. Watch the student do the procedure.
     3. Circle Yes or No about a student’s performance of each step.
     4. Count the steps they did correctly.

Student’s name: ________________________________ Date: __________
                                                                                    Yes No
1.
                                                                                    Yes No
2.
                                                                                    Yes No
3.
                                                                                    Yes No
4.


Number of correct steps: ______

Comments: _____________________________________________
Althea Danielski – Hubbs Center EL Civics 12/18/09                                         25
_______________________________________________________

_______________________________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09   26
                                 Medical Records*

       A resident’s medical record is used to record everything that happens with a

resident’s care. The medical record, or chart, is a written record of a resident’s

condition and their response to treatment and care. It is a permanent and legal

document.

       Professional staff involved in a person’s care can look at the chart. If you have access, you must

keep the information confidential.

       When recording on the person’s chart, you must write clearly, concisely, and thoroughly. Anyone

who reads the chart should know what you observed, what you did, and the person’s response.

       Rules for recording

            1. Always use ink.


            2. Include the date and time for every recording.


            3. Make sure handwriting is neat and easy to read.


            4. Use correct spelling, grammar and punctuation.


            5. Sign all entries with your name and title.


            6. Record only what you observed and did yourself.


            7. Never record a procedure until after it is completed.


            8. Be accurate, concise, and tell the facts. Do not record judgments (I think…)


            9. Use the person’s exact words when possible and put them in quotation marks.


            10. Note any time you talk to a nurse, and include the nurse’s name, what you told her, and the

               time you made a report.

Althea Danielski – Hubbs Center EL Civics 12/18/09                                              27
       *Modified from Basic Skills for Nursing Assistants in Long-Term Care.


Question: What are the reasons behind each rule?




Althea Danielski – Hubbs Center EL Civics 12/18/09                             28
 Look at the following sample of a medical chart. Then answer the questions below.

Date        Time

7/18        1045    Requested assistance to lie down. States, “I don’t feel well. I have a little

                    upset Stomach.” Denies pain. VS taken. T=99 (0). P=76 regular rate and

                    rhythm. R= 18 unlabored. BP 134/84 (L) arm lying down. Signal light

                    within reach. Paula Jones, RN notified of resident’s complaint and VS.

                    Mary Johnson, CNA ------------------------------------------------------------------------------------------------------------------------

            1100    Asleep in bed. Appears to be resting comfortably. Color good. No signs of discomfort
                    0r distress noted at this time. Paula Jones, RN ----------------------------------------
            1145    Refused to go to the dining room for lunch. Complains of nausea. Denies abdominal pain.
                    Has not had an emesis. Abdomen soft to palpation. Good bowel sounds. VS taken.
                    T=99.8 (O) P=76 regular rate and rhythm. R=18 unlabored. BP=134/84 (L) arm
                    lying down. States she will try to eat something. Full liquid room tray ordered.
                    Paula Jones, RN ------------------------------------------------------------------------
 Modified from Basic Skills for Nursing Assistants in Long-Term Care, 2005.


          QUESTIONS:

       1. What is the date for this record? ____________________________________________________


       2. How is the time recorded? ________________________________________________________


       3. At 10:45, who “requested assistance to lie down?”______________________________________


       4. Who is Mary Jensen? Who is Paula Jones? ___________________________________________


       5. Who took the resident’s vital signs (VS) at 11:45? ______________________________________


       6. Did the resident’s temperature change between 10:45 and 11:45? __________________________
 Althea Danielski – Hubbs Center EL Civics 12/18/09                                                                                                  29
   7. Did the resident eat? _____________________________________________________________




Althea Danielski – Hubbs Center EL Civics 12/18/09                              30
                     Medical Chart for ___________________________


  Date        Time      Notes




Althea Danielski – Hubbs Center EL Civics 12/18/09                   31
                       Complete Sentences or Notes?
When we write essays, memos, letters, or emails, we usually write in
complete sentences. When we need to put a lot of information into a small
space, such as a medical chart, we write notes. What is the difference
between complete sentences and notes?
    COMPLETE SENTENCES have five things. Can you list them here?
    1. _________________________________________________



    2. _________________________________________________



    3. _________________________________________________



    4. _________________________________________________



    5. _________________________________________________

Can you write a complete sentence here, as an example? Describe what your teacher is doing right now.
_________________________________________________________________________________


If the subject is clear and understood by the reader and writer, NOTES do not need a subject. They may
start with a verb, like this:   Asleep in bed.
They do, however, need a complete idea. Which of the following are not good notes? Why?
        Refused to go to the dining room.             Refused to go to.
        Has not had.                                  Has not had a bowel movement.
Capitalization (of the first letter) and punctuation (at the end of a sentence) are usually used with notes,
especially when several notes are written together. They help to show where one note ends and the next
begins. Can you fix the notes below, adding proper capitalization and punctuation?
   denies naseau or abdominal pain has not vomited in 4 hours requesting food full room tray ordered
Abbreviations and acronyms are often used to make notes shorter. Do you know what the acronyms in the
following notes mean?
        VS taken. T=99.8 (O). P=76. R=18 unlabored. BP 134/84 (L) arm lying down. Paula Jones, RN.

Althea Danielski – Hubbs Center EL Civics 12/18/09                                                 32
Can you write a few notes here, as an example? Describe what your teacher is doing right now.
_________________________________________________________________________________


                                 Writing Notes in a Medical Chart
Part I
Read the following description of a resident’s condition and activities. Write notes in the medical chart to
document her condition and activities, and what care you have provided.


Maryann Adams is a resident under your care. Normally when you arrive at work you help her get up and
move to the commode (a toilet chair). Then you clean her, get her dressed, and help her walk to the dining
room for breakfast.
This morning, however, Mrs. Adams does not seem well. When you greet her at 7:10 AM, she complains
that she didn’t sleep very much last night, she has a headache, and she feels nauseous. She says she
wants to use the commode right away, but does not want to eat breakfast. As you help her move to the
commode she groans and complains of stomach pain. Her skin feels warm and sweaty. After she uses the
commode you clean her and move her back into her bed. You look in the commode and notice that the
stool is a brown liquid. You notify Angela Sanchez, the nurse on duty, who asks you to take her
temperature. You take Mrs. Adam’s temperature orally; her temperature is 100.8. Nurse Sanchez then
arrives to talk to Mrs. Adams, and you write all this information in the chart.
Use the medical chart you made yesterday to write notes describing the situation above.


Part II
Now watch a video run by your teacher of a nursing assistant helping Mrs. Adams to eat. Imagine this is
the next day, you are that nursing assistant. What notes would you write to describe the interaction?




Althea Danielski – Hubbs Center EL Civics 12/18/09                                                33
                                                           Fact or Opinion?

               Read the statements on the cards and decide if they are facts or opinions. Place each card in the right category.


                             FACT                                                                     OPINION




Althea Danielski – Hubbs Center EL Civics 12/18/09                                             34
Teacher: Cut out the strips to use in the boxes above. Students can do the exercises individually or in
pairs. Answer key: numbers 1, 3, 6 & 7 are facts. 2, 4, 5 & 8 are opinions.




  1. Mrs. Isert has a temperature of 102.1 F.




  2. Mrs. Isert says she feels hot one minute, and
     cold the next.



  3. Mrs. Isert doesn’t want to eat.




  4. The nurse thinks Mrs. Isert has an infection.



  5. You feel like Mrs. Isert should drink more
     fluids.



  6. The doctor orders an IV for Mrs. Isert.



  7. Mrs. Isert takes two Tylenol with some apple
     juice.



  8. Mrs. Isert thinks she has a bladder infection.




Althea Danielski – Hubbs Center EL Civics 12/18/09                                              35
                                              Reference


                                       Copyrighted Materials

Basic Skills for Nursing Assistants in Long-Term Care, S. Sorrentino & B. Gorek, 2005. St. Louis, MO:
Elsevier Mosby.
       Pages 171-173 – Health Records
       Pages 273-177 – Feeding a Resident
       Chapters 2, 9, 17 and glossary – Background information for teachers

MnCareers 2009, Denise Felder, Ed., 2009. St. Paul, MN: iSeek Solutions, Minnesota State Colleges and
Universities.
       Pages 4-7 – Interest Survey

Read to Work: Health Occupations, Phyllis Dutwin, 1997. Upper Saddle River, NJ: Cambridge Adult
Education.
       Lesson 10: Working as a Nurse Assistant, Distinguishing Fact from Opinion
       Extension activities: Lessons 1, 2, 9, 12, Glossary and Page 40.


                                           On-Line Videos

Nursing Assistants
   1. www.youtube.com/watch?v=pg43mfFBqf4
   2. www.youtube.com/watch?v= ho_cY9qoAFw
   3. www.youtube.com/watch?v=QtcX713_a4U

How to help someone sit up in bed
  4. www.youtube.com/watch?v=UDJ8BkRO6iM&feature=PlayList&p=BF2F41740719045B&playne
      xt=1&playnext_from=PL&index=40

Feeding a resident
   5. www.youtube.com/watch?v=TFhbmeS3FZc&feature=PlayList&p=BF2F41740719045B&playnex
       t=1&playnext_from=PL&index=5




Althea Danielski – Hubbs Center EL Civics 12/18/09                                          36

				
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